MEDICARE: CONVENTIONAL WELLNESS HOME HEALTH INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	299992987	FL

General Provider Information

NPI Number	:	1841478906
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONVENTIONAL WELLNESS HOME HEALTH INC

Provider Business Mailing Address
First Line	:	5901 NW 151ST ST
Second Line	:	SUITE#206
City	:	MIAMI LAKES
State	:	FL
Zip	:	33014-2454
Country	:	US
Telephone Number	:	305-231-2001
Fax Number	:	305-231-2002

Provider Business Practice Location Address
First Line	:	5901 NW 151ST ST
Second Line	:	SUITE#206
City	:	MIAMI LAKES
State	:	FL
Zip	:	33014-2454
Country	:	US
Telephone Number	:	305-231-2001
Fax Number	:	305-231-2002

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. NORA LOZANO
Credential	:
Telephone Number	:	305-231-2001

Provider Enumeration Date	:	01/31/2008
Last Update Date	:	05/13/2008

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